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Outcomes of primary graft failure in acute myeloid leukemia patients following unrelated transplantation with post-transplant cyclophosphamide:a study from the ALWP/EBMT
No full textWe assessed pGF in 2497 AML patients undergoing HSCT from 8-10/10 HLA-matched UD with PTCy. pGF was defined as failure to achieve an ANC ≥ 0.5 × 109/L by day +30 after HSCT. The day +30 cumulative incidence of ANC was 92.6% (95%CI: 91.5–93.6), and the incidence of death without ANC recovery was 1.8% (95% CI: 1.3%–2.3%), corresponding to 141 (5.6%) patients not achieving an ANC ≥ 0.5 × 109/L by day +30. PB was the graft source in 89.4% of the patients, and 56% received reduced-intensity conditioning. 21 patients underwent a second HSCT (15 in the absence of ANC recovery and 6 after ANC recovery). 1-y NRM and RI post-pGF were 22.1% and 22.4%, respectively. 1-y LFS and OS post-pGF were 59% and 55.5%, respectively. ANC recovery evaluated as a time-dependent covariate, KPS ≥ 90, and being in CR at the time of HSCT were associated with improved OS. In conclusion, the incidence of pGF post-unrelated HSCT with PTCy was 5.6%. Of the patients who failed to engraft by day +30, 70.9% did so by day +60. A second transplant can save some of the patients with pGF.</p
A novel deep-learning approach for coronary artery calcium scoring in contrast-enhanced spectral coronary CT angiography:A phantom study
No full textBackground: To evaluate whether deep-learning virtual non-contrast (VNC) images derived from dual-layer spectral coronary CT angiography (CCTA) can replace a dedicated coronary artery calcium (CAC) scoring CT scan. Methods: A thoracic phantom containing five cylindrical calcifications (75 to 800 mg/cm3) was scanned on a spectral dual-layer CT with a dedicated non-contrast CAC CT protocol and non-contrast coronary CT (CCT) and contrast-enhanced scans of the CCTA protocol. For CAC CT and non-contrast CCT, the insert was water-filled; for contrast-enhanced CCTA, it was iodine-filled at 400 Hounsfield units at 120 kVp. CCTA images were reconstructed with thick (3.0 mm) and thin (0.67 mm) slices. A deep learning model was trained to detect calcium in spectral CCTA data and used to reconstruct VNC images. Agatston scores were computed per calcification; non-overlapping 95 %-confidence intervals with CAC CT defined statistical significance. Results: Using thick slices, Agatston scores from VNC demonstrated no significant differences compared to CAC CT and CCT, except for significant underestimation of VNC at 100 mg/cm3 (4; 95 % CI: −4 to 12) compared to CAC CT (20; 95 % CI: 16 to 25). Using thick slices, Agatston scores from VNC did not significantly differ from CAC CT for any calcification. For both slice thicknesses, non-calcified regions were correctly quantified with an Agatston score of 0. Conclusion: This phantom study demonstrates the feasibility of CAC quantification in spectral CCTA using deep learning. After clinical optimization and validation, VNC could potentially eliminate the need for separate CAC CT scans, reducing radiation exposure and clinical workload.</p
Biomass-based efficient and eco-friendly adsorbent for chloridazon and its metabolites
No full textChloridazon, a widely applied herbicide in European sugar beet farming, and its degradation products (desphenyl-chloridazon and methyl-desphenyl-chloridazon) are frequently found in surface waters, raising environmental and health concerns. Among the available treatment methods, adsorption stands out as an efficient and economical option, making the search for low-cost, high-performance sorbents essential. In this study, waste coffee grounds were converted into hierarchical porous carbon (HPC) with a specific surface area of about 900 m2·g−1 and further activated using CO2 at 800 °C to yield an enhanced material (aHPC) with a surface area near 1100 m2·g−1. Both adsorbents reached equilibrium within 20 minutes, with aHPC exhibiting notably higher uptake—448 mg·g−1 (chloridazon), 281 mg·g−1 (desphenyl-chloridazon), as well as 294 mg·g−1 (methyl-desphenyl-chloridazon)—surpassing commercial activated carbon and other reported adsorbents. This outstanding performance is attributed to the hierarchical porous structure which at the same time allows for optimal water transport through the adsorbent and facilitates contact of the target molecules with the walls in the micro- and mesopores. Isotherm analysis favoured the Freundlich model, the kinetics followed a pseudo-second order law and thermodynamic measurements indicated the process to be exothermic in nature. X-ray photoelectron spectroscopy analysis identified hydrogen bonds and π–π interactions as driving forces for contaminant binding.</p
De gemeentelijke zorgplicht in de nafase van lokale (mini-)crises:Aandachtspunten uit recente casuïstiek
No full textEen gebeurtenis is vaak niet voorbij als hulpdiensten de locatie verlaten of de crisisorganisatie is afgeschaald. Na de acute fase worden de gevolgen en de omvang van deschade (vaak) pas echt zichtbaar. In deze zogenoemde ‘nafase’ hebben gemeenten eenzorgplicht richting hun inwoners. Het doel van dit inventariserend onderzoek is om aan dehand van praktijkcasussen inzichtelijk te maken wat de nafase van een (mini-)crisis vraagtvan gemeenten en hoe zij invulling hebben gegeven aan de zorgplicht richting hun inwonersin deze nafase. Inzicht in wat er allemaal op gemeenten afkomt in de nafase draagt bij aankennisontwikkeling op dit thema. In totaal zijn tien casussen bestudeerd. Dedataverzameling heeft plaatsgevonden via een literatuur- en documentstudie en viainterviews met functionarissen die betrokken zijn geweest bij de geselecteerde casuïstiek.Er kan geconcludeerd worden dat veel op gemeenten afkomt in de nafase van eenimpactvolle gebeurtenis. In de nafase verrichten gemeenten allerlei inspanningen ominvulling te geven aan de zorgplicht richting hun inwoners. Voor gemeenten begint het werk(voornamelijk) tijdens de overdracht van de gebeurtenis van de acute fase naar de nafase.Dit onderzoek laat zien dat die ‘warme’ overdracht vaak maar matig uit de verf komt. Hetwas voor functionarissen zoeken wat er voor de overdracht gedaan moest worden en opwelk moment, op welke wijze en aan wie er overgedragen moest worden. Besluitvormingover de invulling van de nafase vond ook niet altijd plaats. Daarnaast werden beperkt(vooraf) uitgangspunten geformuleerd, niet over het ‘wat’, maar ook niet over het ‘hoe’. Deorganisatie van de nafase werd vooral pragmatisch vormgegeven. Slechts een enkele keerwerd een meer gestructureerde aanpak gehanteerd. Afhankelijk van de thema’s die erspeelden, werden gemeenteambtenaren gevraagd een bijdrage te leveren aan de nafase –zonder dat ze beschikten over specifieke kennis of ervaring met de nafase, al waren er welvaak raakvlakken met het reguliere werk.Verschillende thema’s speelden een belangrijke rol in de nafase. Zo is een zorgvuldigecommunicatie belangrijk voor een goede relatie met getroffenen. Allerlei communicatiemiddelen werden ingezet, maar soms was de communicatie toch niet toereikend. Een aantalkeren opende de gemeente een centraal punt waar inwoners naar toe konden met hunvragen en waar ze ondersteuning konden krijgen op diverse vlakken (eenloketfunctie).Psychosociale zorg en ondersteuning werden vooral direct ingezet bij gebeurtenissen metdoden en/of gewonden. Bij gebeurtenissen waar met name de leefomgeving werdaangetast, duurde het langer voordat die ondersteuning werd ingezet.Hoewel het herstellen van woningen, vervangende woonruimte organiseren en deafwikkelen van schade geen directe verantwoordelijkheid van gemeenten zijn, wil dat nietzeggen dat gemeenten geen inspanningsplicht hebben op die gebieden. Ten slotte isopvallend dat van vrijwel iedere gebeurtenis de acute fase werd geëvalueerd, maar dat hetevalueren van de nafase niet vanzelfsprekend is. Ook werd de geboden zorg aangetroffenen vrijwel niet (tussentijds) gemonitord of geëvalueerd. De organisatie van denafase vraagt aldus om meer bewustzijn van de taak, om een verantwoordelijkheid die meer vraagt dan een pragmatische aanpak, en om duidelijker sturing en coördinatie, inclusief devoorbereiding daarop.Een gebeurtenis is vaak niet voorbij als hulpdiensten de locatie verlaten of de crisisorganisatie is afgeschaald. Na de acute fase worden de gevolgen en de omvang van de schade (vaak) pas echt zichtbaar. In deze zogenoemde ‘nafase’ hebben gemeenten een zorgplicht richting hun inwoners. Het doel van dit inventariserend onderzoek is om aan de hand van praktijkcasussen inzichtelijk te maken wat de nafase van een (mini-)crisis vraagt van gemeenten en hoe zij invulling hebben gegeven aan de zorgplicht richting hun inwoners in deze nafase. Inzicht in wat er allemaal op gemeenten afkomt in de nafase draagt bij aan kennisontwikkeling op dit thema. In totaal zijn tien casussen bestudeerd. De dataverzameling heeft plaatsgevonden via een literatuur- en documentstudie en via interviews met functionarissen die betrokken zijn geweest bij de geselecteerde casuïstiek
Fracture-Related Infection:Towards diagnostic uniformity and optimised treatment strategies
No full textAfter surgical treatment of a bone fracture, an infection can sometimes develop around the bone and the implanted hardware. This condition is known as a fracture-related infection (FRI). FRI is a serious complication that can significantly delay recovery, affect quality of life, and lead to substantial healthcare costs.In recent years, an international consensus definition of FRI has been established. This has improved the recognition of these infections and enabled better comparison between studies. However, many uncertainties remain regarding the optimal diagnosis and treatment of FRI.This dissertation aims to improve the understanding of FRI and to optimise its treatment. It shows that commonly used criteria for surgical site infections often fail to detect FRI, while dedicated FRI criteria are more reliable. The research also demonstrates that the timing of infection onset does not reliably predict the responsible bacteria, which has important implications for antibiotic selection.Various treatment strategies are evaluated. The findings suggest that both single-stage and two-stage surgical approaches can achieve good outcomes, and that retaining implanted hardware may be possible even several weeks after the initial surgery. The use of antibiotic-loaded bone substitutes appears to reduce the risk of recurrent infection. Given the complexity of FRI, there is an urgent need for large international collaborations using uniform terminology to gather high-quality data and develop new, alternative treatment strategies
AI performance for nodule volume doubling time in the follow-up of the UKLS lung cancer screening study compared to expert consensus and histological validation
No full textAim: To validate an artificial intelligence (AI) software for automated assessment of nodule growth by volume doubling time measurement (VDT) on protocol-mandated follow-up low-dose CT (LDCT) scans from the UK lung cancer screening (UKLS) trial. Methods: This validation study included 710 UKLS participants with 939 LDCT follow-up scans (361 3-month and 578 12-month). Follow-up scans were assessed independently by both AI and human readers. A positive finding warranting referral was defined as the largest nodule with a solid component ≥ 100 mm3 showing VDT ≤ 400 days at follow-up. Performance was benchmarked against the European expert panel (reference standard) and then the histological outcomes (gold standard). Results: Against the expert panel, AI achieved the lowest 3-month negative misclassification (NM) rate (1/11, 9.1 %), versus human readers (range: 18.2–63.6 %). AI’s positive misclassification (PM) rate was initially 7.8 % (28/361) at 3 months but decreased to 0.9 % (5/578) at 12 months. Against histological outcomes of 9 screen-detected lung cancers, AI identified VDT ≤ 400 days in all 4 cancers also deemed positive by the expert panel at the earliest 3-month follow-up, while human readers missed or delayed referrals in 1–3 of these. AI also identified VDT ≤ 400 days in 3 of 5 cancers that the panel classified as negative, primarily due to their sub-threshold volume (<100mm³). Conclusions: The automated AI system showed strong VDT assessment performance in follow-up screening, outperforming human readers in the early identification of rapid growth in histologically-confirmed cancers, thus supporting its potential to enhance risk stratification and facilitate earlier lung cancer detection.</p
Group singing in cognitive decline – what it is and how it is done. A systematic search and review
No full textGroup singing is an effective nonpharmacological approach used to support wellbeing and social connection for older adults living with cognitive decline. However, the precise designs of group singing research studies are subject to variation. Therefore, the central aim of this systematic search and review was to identify studies that applied group singing as a key element of their methodology, and compare the relevant details of its implementation. The 23 reviewed studies varied considerably in their implementation strategies and group sizes. However, some consensus emerged: most sessions, for instance, included singing familiar songs with participants well over 70 years of age who were predominantly female. Sessions typically took place once a week, lasted more than one hour, and were held over 2–3 months, leading to a mean of 14 sessions. This accumulated information could be used to guide the planning of future studies for people with cognitive decline.</p
Persistent spin texture protected by the approximate symmetry in a weakly interacting graphene/WTe<sub>2</sub> heterostructure
No full textCrystal symmetries in solids give rise to spin-momentum locking, which determines how an electron's spin orientation depends on its momentum. This relationship, often referred to as spin texture, influences both charge-to-spin conversion and spin relaxation, making it one of the essential characteristics for spin-orbit-driven phenomena. Materials with strong spin-orbit coupling and broken inversion symmetry can host persistent spin textures (PSTs)—unidirectional spin configurations in momentum space, supporting efficient charge-to-spin conversion and extended spin lifetimes. Monolayer WTe2, a topological material crystallizing in a rectangular lattice, is a notable example; its symmetry enforces a canted PST, enabling the quantum spin Hall effect with the nontrivial spin orientation. Here, we use first-principles calculations to explore how these properties are modified when WTe2 is interfaced with graphene. We find that the PST is preserved by the local symmetry present in different regions of the heterostructure, while the system develops extended electron and hole pockets, resulting in semimetallic behavior. Although the bandgap closes and eliminates the quantum spin Hall phase, spin Hall effects remain robust in both conventional and unconventional geometries. The computed spin Hall conductivities are comparable to those of other two-dimensional materials, and the survival of the PST suggests the possibility of long-range spin transport even in the absence of topological edge states. In addition, the graphene layer serves as an oxidation barrier, helping protect the intrinsic properties of WTe2 and supporting the potential of this heterostructure for spintronic applications.</p
Examining biases and contextualization issues in research:A critical reflection on Pratto et al.'s (2023) study on empathy, counter-dominance, and support for intergroup violence
No full textAge and Conflict Management in the Workplace
No full textAs workforces age across industrialized societies, organizations are increasingly characterized by greater age diversity. This chapter examines how employee age relates to conflict management in the workplace. Drawing on lifespan theories of emotional development and organizational conflict research, we review literature suggesting that older employees tend to rely more on constructive conflict management strategies (e.g., problem-solving, compromising, accommodating, and avoiding) and less on destructive strategies (e.g., forcing), compared to younger employees. These age-related differences are linked to enhanced emotional abilities of older employees, including better emotion regulation, and to greater prioritization of relational harmony. Age differences in conflict management are not uniform, however, as their magnitude and sometimes even their direction may depend on important boundary conditions, including individuals’ hierarchical roles, conflict types (e.g., task vs. relationship conflict), and motivational traits (e.g., generativity). Finally, we discuss practical implications for fostering age-inclusive and conflict-competent workplaces